Pneumothorax in teenagers: reducing recurrence through resection of superior segment of lower lobe
Autor: | Toshihiko Moroga, Akinori Iwasaki, Jun-ichi Wakahara, Naofumi Miyahara, Toshiro Obuchi, Yasuhiro Yoshida |
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Rok vydání: | 2018 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry 030204 cardiovascular system & hematology Lateral side medicine.disease Asymptomatic Surgical methods Surgery Resection 03 medical and health sciences 0302 clinical medicine Lower lobe 030228 respiratory system Pneumothorax Medicine In patient Original Article medicine.symptom business Pathological |
Zdroj: | Journal of thoracic disease. 10(6) |
ISSN: | 2072-1439 |
Popis: | Background: Spontaneous pneumothorax in young patients is characterized by a high recurrence rate. We retrospectively investigated causes of recurrence and effective surgical methods to improve this statistic, in particular through resection of the superior segment of the lower lung lobe (S6a). Methods: From April 2011 to September 2017, we performed 146 operations for 126 lateral side pneumothoraces in patients 20 years of age or younger (105 males and 7 females, mean age 17.2 years) at our institution. Two groups—one with patients who underwent both apical bullectomy and S6a resection (the S6a group), and the other with patients who underwent only apical bullectomy with apical reinforcement using an absorbable mesh sheet (the AB group)—were statistically compared in terms of recurrence rate. Results: A significant difference was found between the S6a group and the AB group in terms of the number of S6a recurrences (0 vs . 8 cases, respectively; P=0.025), although there was no significant difference between the two groups in terms of the total recurrence rate (16.1% vs .18.6%, respectively). Pathological examination revealed that 55 of the 56 (98.2%) S6a specimens already contained asymptomatic, non-ruptured bullae or microscopic bullous lesions at the time of the initial operation. Conclusions: In addition to the apex, the S6a often involves lesions responsible for pneumothorax recurrence. To reduce this recurrence in teenage patients, we suggest that S6a resection be concomitantly performed in the initial operation—even if there are no macroscopically visible blebs on the S6a. |
Databáze: | OpenAIRE |
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